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 A Science Student's View of Science in Daily Life
Cyclohexane (C6H12): Chair Conformation.  Cyclohexane is a hydrocarbon consisting of a ring of carbon atoms, each bonded to two hydrogen atoms.  Pictured is a 3-D model of the most typical arrangement of its atoms in space, as visualized in two dimensions by convention.  

Disclaimer:  These essays represent the views of a former natural science student and retired clinical trials lead statistical programmer/analyst.  Nothing in these essays should be interpreted as a recommendation for a scientific experiment.  The essays that this page lists do not challenge medical orthodoxy, although some of them examine skeptically recent moves to overturn it that are wrongly and hastily honored by the authorities.  For more details about the background of the author, Dorothy E. Pugh, see About Us

Are there good reasons to study science even if one isn't headed toward a science career?  One is that we need to be good clients of science.  When we get physical exams, we need to understand all of the standard lab tests and their implications.  Are we getting all the tests we need?  What are the full implications of out-of-range values?  Will they lead to potentially harmful further tests or treatments, taking into consideration what only we can know about our health?  What questions should we ask our physicians?  What is a satisfying answer?  Reading explanations of standard blood and urine tests is basic, but taking an anatomy and physiology course is even better.

Another consideration that we cannot afford to overlook is how science is used to determine public policy.  This becomes especially important when our government takes surprise measures that inflict harm on us and which it claims are supported by vague references to "science".  We should have the right to ask what justifies these measures, and to protest if the answers that we get do not satisfy us.  The more scientific sophistication we have, the deeper we can dig.  If we do not do this, we are submitting to a type of dictatorship. 

What can people who are not trained professional scientists call attention to?  One is an increasing problem of scientists and physicians operating outside their specialties who are setting influential public policies.  This requires a basic knowledge of what each specialty does, i.e., what we require of specialists in these areas even though we might not know the specifics of how they practice it.  For instance, virologists are mainly laboratory scientists who study viruses interacting with human cells and design vaccines and antiviral drugs; then they guide clinical trials for these vaccines and antiviral drugs.  These skills might give them a rough idea of how dangerous these viruses are, information which is most useful before thy escape into the population.  However, after they do so, epidemiologists, who are experts at collecting and analyzing population data, are best at determining this.  Another concern, of course, is how to mitigate the spread of the virus by purely physical means, e.g., by improving ventilation systems and installing physical barriers that block virus movement while imposing little or no misery on the population.  Engineers are the experts in this area.

This public policy issue came to a head during the COVID-19 pandemic, when mandates and restrictions were imposed, apparently because of decisions made on the part of a single official science advisor who was a virology specialist, while the head of the Centers for Disease Control (CDC), was also a virologist. However, epidemiology was left out of the picture, and as a result, the data needed to measure the severity of COVID-19 were hidden from the public, while we were given case, hospitalization, ventilation, and death totals and told to assume that there was a very high death rate from COVID because these were big numbers and that this in turn justified draconian coercive measures.  Academic epidemiologists tried to modify this picture, but these two virologists did not listen to them.  Later on, concerns about conflicts of interest on the part of this decision-maker arose but were ignored by our administration.  Our current (2022) CDC director was left to analyze the data in a more useful fashion, e.g., distinguishing those who died of COVID and those who simply died with it.  In sum, we Americans got a crash course in how not to apply science to public policy.

On the other hand, the changes brought to medical care via the Affordable Care Act mostly flew under the radar.  Because it entailed greater government payouts, cutting medical care costs became a top priority.  This involved a campaign to identify and eliminate "low quality" care.  Indeed, as some insurance companies pointed out, some care simply didn't make sense, e.g., performing Pap smears on women who had had hysterectomies.  But the definition of "low quality" care was expanded to include care that did indeed benefit some people but was deemed too expensive by cost-benefit analyses, conducted by bureaucrats based on their (mis)understanding of relevant clinical trials.  This targeted most screening tests, i.e., those administered to patients without apparently relevant signs, symptoms, or risk factors.  These tests involved the overwhelming majority of blood tests and all urinalyses.  Unfortunately, many of the conditions triggering positive results in these tests lack distinctive signs and symptoms, and many have none.  Just three of such conditions are (early) bladder cancer, thyroid disease, and hypercalcemia; the latter can indicate a variety of serious conditions including several types of cancer and typically has no symptoms.  A key player here is the U.S. Preventive Services Task Force, begun as an advisory group in 1984, but whose recommendations have now taken on legal force.

Our federal government does keep the public informed about its executive branch policy decisions in great detail as required by the Administrative Procedure Act of 1946.  Its websites contain information designed to be understood by the average citizen.  This Act even provides for 30-day public comment periods on proposed rulings by its agencies.  Perhaps the most important information citizens should know are the basics of what is considered to be standard medical practice today, i.e., what one is likely to encounter at an annual physical exam.  These web pages provide this information:

https://www.healthcare.gov/preventive-care-adults/

https://www.healthcare.gov/preventive-care-women/

https://www.healthcare.gov/preventive-care-children/

 

In this spirit, I have written the following essays:

Essays

Major essays (heavily researched literature reviews)

"Subclinical" Hypothyroidism: Is Restricting Treatment Based on Science or on Politics?  (begun January 22, 2013, with continual revisions through September 26, 2021)

Bubble, Bubble, Toil and Trouble: The Hard Problem of (Very) Soft Water   (Major revisions on July 27-August 21, 2008)

My Two Cents on the Cost of U.S. Medical Care   (July 11, 2008)

Bat Viruses, Gain-of-Function Research, and National Security   (July 31, 2021)

 

Thinking outside the box: hypotheses worth pursuing

The Migraine Mechanism: an idea

Common Sense about Fevers (February 26, 2022)

Race, Age, and Other Surrogate Variables: Are We Really Thinking This Through? (September 18, 2020)

Noses and Common Sense in the Time of COVID-19  (September 5, 2020)

NOAA Ship Okeanos Explorer Live Cam Stills: Ocean Animals (July 14-15, 2017)

An Unprecedented Disaster or Just the Tip of the Iceberg? Lessons from a Recent Medical Scandal (May 19, 2017)

A New Regulatory Catch-22: Hypothyroidism and Depression (October 21, 2016)

In Defense of the EpiPen: Human Factors and Social Progress (August 28, 2016)

My Two Cents on Climate Change (February 17, 2015)

What about the water in climate change models? (January 6, 2014)

How Chemistry and Physics in the Kitchen Might Affect Your Biology  

How to Ask a Good Naïve Question  

Mitral Valve Prolapse: Personal Thoughts (December 16, 2016)

 

Copyright © 2013-2022 by Dorothy E. Pugh

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